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Published on: August 24, 2019
The relationship between inspiratory muscle strength and exercise tolerance in patients with coronary heart disease
Tao Shen1, Jinglin Li2,3, Yanxin Song2
1Department of Cardiology, Peking University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, China. fengguxuan@163.com.
Insights
Inspiratory muscle weakness (IMW) in coronary heart disease (CHD) patients post-percutaneous coronary intervention (PCI) is linked to reduced exercise capacity. Comorbid chronic obstructive pulmonary disease (COPD) exacerbates this decline.
Area of Science:
- Cardiology
- Pulmonology
- Exercise Physiology
Background:
- Limited research exists on exercise capacity in coronary heart disease (CHD) patients after percutaneous coronary intervention (PCI) who have inspiratory muscle weakness (IMW).
- Assessing exercise capacity is crucial for rehabilitation and management of these patients.
Purpose of the Study:
- To investigate the relationship between inspiratory muscle strength and exercise capacity in post-PCI CHD patients.
- To identify factors associated with inspiratory muscle weakness in this population.
Main Methods:
- Retrospective cohort study of 571 CHD patients who underwent PCI.
- Inclusion criteria: patients with available data from inspiratory muscle testing and cardiopulmonary exercise testing (CPET).
- Clinical data, including maximal inspiratory pressure (MIP), peak oxygen uptake (VO₂peak), and oxygen uptake efficiency slopes (OUES), were analyzed.
Main Results:
- 9.8% of patients exhibited IMW (average MIP: 90.7 ± 26.1 cm H₂O).
- Patients with IMW showed significantly lower VO₂peak and OUES compared to those without IMW.
- MIP strongly correlated with VO₂peak and OUES.
- VO₂peak and a history of chronic obstructive pulmonary disease (COPD) were independent risk factors for IMW.
Conclusions:
- Inspiratory muscle weakness is associated with reduced exercise tolerance and oxygen uptake efficiency in post-PCI CHD patients.
- Comorbid COPD is a significant risk factor for IMW in this patient group.
- These findings highlight the importance of assessing inspiratory muscle function in CHD patients post-PCI.
Background:
There has been insufficient research on the assessment of exercise capacity in patients with coronary heart disease (CHD) following percutaneous coronary intervention (PCI) who exhibit inspiratory muscle weakness (IMW).
Methods:
A retrospective cohort study involving CHD patients who underwent PCI at Peking University Third Hospital Heart Rehabilitation Center between January 2019 and December 2021 was conducted. Patients who had undergone inspiratory muscle testing and cardiopulmonary exercise testing (CPET) were included, and their clinical data were collected and analyzed.
Results:
A total of 571 post-PCI CHD patients were included in the study. The average age was 60.8 ± 4.3 years, and 479 male patients (83.9%) were included. The average maximal inspiratory pressure (MIP) of the enrolled patients was 90.7 ± 26.1 cm H2O, with 56 patients (9.8%) presenting with IMW. The IMW group had lower peak oxygen uptake (VO2peak) (17.4 ± 4.2 vs. 19.3 ± 5.1 mL/ /min/kg, p < 0.001) and oxygen uptake efficiency slopes (OUES) (1464.7 ± 368.5 vs. 1619.2 ± 400.4, p = 0.004). MIP correlated with VO2peak (r = 0.719, p < 0.001) and OUES (r = 0.622, p < 0.001). Multivariate regression analysis revealed that VO2peak (OR = 0.917, 95% CI = 0.858 ~ 0.980) and history of chronic obstructive pulmonary disease (COPD) (OR = 1.705, 95% CI = 0.934~ 3.112) were independent risk factors for IMW.
Conclusions:
After PCI, CHD patients exhibiting IMW, especially those with comorbid COPD, demonstrated reduced exercise tolerance and oxygen uptake efficiency.
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